Iatrogenic Cushing’s syndrome in a infant due to prolonged use of topical corticosteroids. Case report

Abstract

Introduction: Cushing’s syndrome (CS) is an endocrine disease by to glucocorticoids excess, dependent or independent of adrenocorticotropic hormone (ACTH). The main cause is iatrogenic due to excessive use of glucocorticoids.

Objective: To show the association between prolonged use of topical corticosteroids and the development of CS.

Clinical Case: An infant treated with topical corticosteroids due to seborrheic dermatitis. Due to long-term unsupervised use, he develops Cushing’s syndrome characterized by obesity and compromised growth rate. Topical use of corticosteroids was discontinued and physiological replacement therapy was initiated with descending doses, achieving clinical improvement.

Discussion: Topical corticosteroids are widely used in clinical practice for management of dermatological pathologies. These are available in various presentations with variable efficiency. The main determining factors in its action are the characteristics of the skin, the active principle of the drug, the potency and application technique, so that the adverse effects are observed more frequently in the use due to diaper dermatitis. The main adverse effect of long-term use is Cushing’s syndrome which can be prevented through supervised use and progressive decrease.

Conclusion: The rational and careful use of topical corticosteroids is essential to take advantage of the beneficial effects and avoid adverse effects.